Andrea Petersen, Untangling from Anxiety
Andrea Petersen, a Wall Street Journal reporter and author of "On Edge: A Journey Through Anxiety," discusses her personal battle with anxiety, panic disorder, and agoraphobia, and the treatments she found effective. She also explores the science of anxiety, its rising rates in young people, and the role of social media.
Deep Dive Analysis
15 Topic Outline
Host's Experience with Claustrophobia and Meditation
Advice on Finding a Meditation Teacher
Andrea Petersen's Personal Journey with Anxiety
First Severe Panic Attack and Initial Misdiagnoses
Discovery of Anxiety Diagnosis and Cognitive Behavioral Therapy
Relapses, Medication, and Managing Anxiety in Adulthood
Delineation Between Anxiety, Panic, and Depression
Societal and Biological Factors for Higher Anxiety in Women
Optimism for Future Anxiety Treatments and Stigma Reduction
Cognitive Behavioral Therapy (CBT) Explained
Enhancing the Effectiveness of CBT and Other Novel Treatments
Rising Rates of Anxiety Among Young People
Impact of Social Media on Youth Mental Health
Andrea Petersen's Approach to Mindfulness Through Yoga and Baking
Host's Meditation Advice: Reframing Distraction and Doubt
7 Key Concepts
Anxiety
Anxiety is defined as the anticipation of pain, whether physical or emotional, making it a future-oriented state focused on what could happen. It differs from fear, which is more concrete, and becomes a disorder when it impairs one's ability to live life as desired.
Panic Attack
A panic attack is characterized by sudden, intense periods of physical symptoms like a racing heart, shortness of breath, chest pain, and an overwhelming fear of going crazy or dying. It is a specific diagnosis within the family of anxiety disorders, with defined criteria for duration and impact on daily life.
Cognitive Behavioral Therapy (CBT)
CBT is the most evidence-based talk therapy for anxiety disorders, primarily involving exposure and cognitive restructuring. It systematically and gradually exposes individuals to their fears while challenging irrational thoughts about potential negative outcomes.
Exposure Therapy
A core component of CBT, exposure therapy involves gradually and systematically confronting the very things one is afraid of, starting with less frightening scenarios and progressing to more challenging ones. The goal is to provide evidence that feared outcomes do not occur, thereby reducing anxiety.
Cognitive Restructuring
This is the cognitive part of CBT, where individuals challenge their anxious thoughts by examining the evidence for and against their fears. It involves questioning the likelihood of feared events and considering alternative, more realistic perspectives.
Mindfulness
Mindfulness is the practice of paying close attention to whatever is happening in the present moment. It is considered the antithesis of anxiety, which is a future-oriented state, and can be cultivated through formal meditation or integrated into daily activities like yoga or even baking.
SSRIs (Selective Serotonin Reuptake Inhibitors)
SSRIs are a class of antidepressant medications, such as Zoloft, Prozac, and Paxil, that are also effective as first-line treatments for anxiety disorders. They work by affecting serotonin levels in the brain.
9 Questions Answered
While specific meditative techniques might help, it requires dedicated effort to research and apply them to the particular area of fear. Simply meditating generally may not automatically resolve specific phobias without targeted application.
There isn't a comprehensive national directory of vetted teachers, but listeners can try Googling for local teachers, checking if favorite teachers are speaking in their area, attending meditation retreats, or inquiring about remote teaching via Skype or phone with teachers they admire.
Anxiety is a future-oriented anticipation of pain, while panic attacks are sudden, intense physical and mental symptoms that are a specific type of anxiety disorder. Depression is often described as backward-looking rumination about past failures, though anxiety and depression frequently co-occur, with anxiety often emerging first.
Evidence suggests hormonal factors, specifically fluctuating estrogen levels, may contribute. Additionally, societal messages where girls are often cautioned about safety and encouraged less independence than boys may fuel feelings that the world is dangerous and they cannot cope alone.
Yes, there is evidence of increasing anxiety rates among young people, with factors like social media, rising college costs, and economic insecurity being potential contributors. However, increased reporting due to reduced stigma also plays a role.
Passively scrolling through social media feeds can increase feelings of loneliness and sadness, while active posting seems less damaging. The 'highlight reel' nature of social media can lead to feelings of inadequacy, especially for those already struggling with anxiety or depression.
Research suggests that taking a nap or engaging in exercise (like running) after CBT sessions can strengthen the learning that occurs during therapy, as exercise boosts proteins that help consolidate memories.
Yoga, especially challenging classes that require full attention to avoid falling, can be a form of 'moving meditation' as it grounds one in the present moment. Baking, with its tactile nature and focus on a physical process, can also be meditative by grounding one in the body and providing a sense of certainty, though it may not be traditional meditation.
The key is to understand that getting lost in thought and then returning to the breath is the 'win,' not a failure. This moment of waking up from distraction is crucial for recognizing mental patterns and preventing thoughts, like doubt or judgment, from governing one's actions.
15 Actionable Insights
1. Prioritize Foundational Self-Care
Consistently prioritize sufficient sleep, good nutrition, and regular exercise, as these are critical for managing anxiety and preventing its exacerbation, making your brain less prone to anxious states.
2. Actively Apply Mindfulness
Make a conscious effort to apply meditative and mindfulness techniques directly to specific areas of your life where you seek change, such as relationships, stress management, or overcoming specific fears, rather than expecting general practice to automatically transfer.
3. Utilize Cognitive Behavioral Therapy (CBT)
Engage in Cognitive Behavioral Therapy, specifically using exposure to gradually face fears and cognitive restructuring to challenge irrational thoughts by examining evidence, which provides proof that feared outcomes often don’t materialize.
4. Reframe Meditation Distraction
View moments of distraction during meditation as a ‘win,’ as waking up to your mind’s wandering is the essential practice that allows you to observe your mental machinery and not be governed by every thought.
5. Address Judgment and Doubt
When judgment or doubt arises during meditation, make a mental note, such as ‘judgment’ or ‘doubt,’ to acknowledge and disengage from these thoughts, preventing them from crippling your practice and life.
6. Start Meditation Small
For beginners or those struggling with time, start with a formal meditation practice of just one minute daily to make it accessible and build consistency, rather than aiming for overly ambitious durations.
7. Consider Medication and Therapy
If anxiety is significantly impairing your life, consider combining medication (like SSRIs) with therapy to prevent avoidance behaviors and the shrinking of your world, as both can be effective treatments.
8. Use Suffering Avoidance as Motivation
Leverage the memory of past suffering or the desire to avoid future distress as a powerful motivator to consistently engage in self-care practices like meditation, sleep, and exercise.
9. Enhance CBT with Post-Session Activities
To potentially strengthen the learning from Cognitive Behavioral Therapy, consider taking a nap or going for a run after a session, as these activities can help consolidate memories.
10. Recognize Clinical Anxiety
Understand that while anxiety is a normal emotion, it becomes a disorder requiring attention when it consistently impairs your ability to live your life the way you want to live it.
11. Explore Alternative Grounding Activities
If formal meditation is challenging, engage in activities like yoga (as a ‘moving meditation’) or baking that are tactile, require present-moment attention, and provide a sense of certainty and grounding.
12. Practice Generosity
Incorporate acts of generosity, such as giving away things you create, as a beneficial practice that can provide positive feedback and connection.
13. Be Mindful of Social Media
Be aware that passively scrolling through social media feeds can increase feelings of loneliness and sadness, while more active engagement (like posting) may be less detrimental to mental health.
14. Seek a Qualified Meditation Teacher
To find a trustworthy meditation teacher, research local options, look for teachers speaking in your area, attend retreats, or inquire about remote teaching via Skype or phone.
15. Explore fMRI Neurofeedback
Investigate fMRI neurofeedback as a potential treatment where you learn to alter your brain activity in real-time to alleviate anxiety symptoms, if you are able to use an MRI scanner.
5 Key Quotes
Anxiety is anticipation of pain. It could be physical pain. It could be emotional pain. So it's this future-oriented state, you know, what could happen.
Andrea Petersen
The moment you wake up from distraction is the win. That is proof that you are not doing it wrong because – why is it important? Because when you see how nuts you are, when the voice in your head offers you a terrible suggestion some point later in the day, usually in your case probably something anxious like, you know, you should be freaking out about the next deadline or whatever. You can see, oh, that is just a thought. I'm nuts like everybody else on this planet because evolution bequeathed us this brain that was designed for threat detection. I don't need to obey the thought.
Dan Harris
My mind just jumps all over the place, which I know is – you can't – I know actually you can't suck at meditation. I mean, I know it's all about the practice. I know this intellectually. But I have not – I have been able to sort of get over the hump of the sort of – how uncomfortable that feeling is of sitting there and feeling like you're doing it wrong.
Andrea Petersen
Anxiety is actually now being looked at as a more – as a developmental disorder that begins in childhood. And – because it's the earliest sort of emerging – one of the earliest emerging mental health issues. It tends to start – it can start as early as in the preschool years. And, you know, anxious kids often can turn into depressed adults.
Andrea Petersen
The fruit of meditation, I believe, especially for one of the main fruits of meditation for people like us just at the beginning stages, is visibility. It's like having an inter-meteorologist that is telling you within the storms about to make landfall and get out of the way.
Dan Harris
2 Protocols
Cognitive Behavioral Therapy (CBT) for Anxiety
Andrea Petersen- Systematically and gradually expose yourself to the very things you are afraid of, starting with the least frightening and working up to your 'emotional Everest'.
- Challenge your anxious thoughts by asking for evidence that the terrible thing you fear will actually happen.
- Consider the likelihood of the feared event based on factual evidence (e.g., age, prior medical checks).
- Recognize that the terrible thing you think is going to happen doesn't happen, providing evidence against your fears.
Basic Meditation Practice
Dan Harris- Sit comfortably, often with eyes closed.
- Bring your full attention to the feeling of your breath coming in and going out.
- When you get distracted, simply start again, reframing the moment of waking up from distraction as a 'win'.